Continuous glucose monitors (CGMs) could transform diabetes management for millions of Americans with type 2 diabetes who don't take insulin, according to findings from new research published in the New England Journal of Medicine.

The clinical trial found that adults using CGMs spent approximately five additional hours each day within their target blood sugar range compared with those receiving routine care. Nearly twice as many CGM users also achieved an A1c level below 7%, a common treatment goal for people with diabetes.

CGMs use a small sensor worn on the body to continuously track glucose levels throughout the day and night. This allows patients to see how their blood sugar responds to food, physical activity and other daily habits, potentially helping them make more informed decisions about managing their diabetes.

“An estimated 20 million adults in the United States have type 2 diabetes and do not take insulin, and despite advances in treatment, many still still do not reach glycemic targets,” said first author Tamara Oser, MD, professor in the University of Colorado Anschutz Department of Family Medicine. “Over time, elevated blood sugar can increase the risk of serious health complications, including heart disease, kidney disease and vision loss, so it’s important we continue to improve care for everyone with diabetes.”

Tamara and her co-authors also found another significant finding: CGM users experienced significantly greater improvements in A1c, a measure of average blood sugar over approximately three months. The difference between the groups was 0.9 percentage points, greatly exceeding the threshold generally considered clinically meaningful.

Largest clinical trial of its kind

The study included 283 adults across 22 U.S. primary care practices who were followed for 26 weeks. It’s the first large-scale, multicenter randomized controlled trial to evaluate the effectiveness and safety of CGM in adults with type 2 diabetes who do not take insulin.

Unlike smaller previous studies, this trial exclusively enrolled patients receiving diabetes care through primary care practices, where most Americans with type 2 diabetes are treated. This approach makes the findings particularly relevant to everyday clinical care.

A new study published in Substance Use & Addiction Journal found that state-level AUD estimates among women ranged from approximately 6-13 percent, with all New England states and several in the West and Midwest exceeding the national average of 8 percent among women. More than 40 percent of addiction treatment facilities did not offer women-specific treatment, and services targeted toward women—especially childcare—were disproportionately unavailable in many states that had higher-than-average estimated AUD prevalence among women. The study was funded by the National Institute on Alcohol Abuse and Alcoholism and is the first to explore state-level differences in AUD among women and the availability of women-specific services in treatment facilities.

By parsing metabolic data from more than 18,000 participants in China, scientists have constructed “clock” models of human aging that can give clues about the risk of chronic diseases and mortality. The comprehensive study provides a treasure trove of data about aging’s impact on metabolism and yields clinically relevant metrics that could guide health monitoring and disease prevention efforts. Aging is a highly complicated process, and scientists have only begun to tease apart how the body’s molecular pathways shift as we get older. In recent years, researchers have sought to identify biomarkers of aging – such as epigenetic markers and changes in metabolic signatures – and integrate them into models called aging clocks. These models might help clinicians identify people who have a higher risk of chronic diseases and could inform early interventions. Now, Linlin Cao and colleagues present results from one of the most comprehensive studies to date of metabolic aging, involving 18,476 participants ranging from one to 96 years of age from six clinical centers in China. They profiled metabolites in plasma samples from the participants and linked 56 metabolites to age-associated shifts. Based on these data, the team derived a metric called metabolomic age acceleration (mAA), which correlated with a higher risk of fatty liver disease, hypertension, diabetes, and all-cause mortality as the cohort aged. The team also examined a disease cohort and uncovered a second metabolic metric called age deviation that was higher in patients with more severe and systemic disease. “Together, these findings support plasma metabolomics as a scalable and clinically interpretable framework for studies of disease prevention, early detection, healthy aging, and aging-related heterogeneity across the life course,” Cao et al. conclude. They add that their age prediction framework is available to the public via a web interface.

By applying mRNA technology and structural engineering, researchers have fashioned an advanced antibody therapy that can neutralize SARS-CoV-2 while constraining the virus’ ability to escape recognition. The therapy protected mice against infections with an immune-evasive Omicron variant, and provides a structural template for antiviral antibodies that can keep up with their constantly evolving viral targets. Although the COVID-19 pandemic is over, SARS-CoV-2 remains a threat to public health, and is especially dangerous for people with compromised immune systems who can’t fully benefit from vaccines. Antibody therapies are critical for these high-risk groups, as they can bind to and neutralize the virus without the need for vaccine-induced immunity. However, like other viruses, SARS-CoV-2 is constantly evolving – and variants quickly appeared that could evade the first generation of antibody therapies. This escape has also undermined the deployment of next-generation antibodies, so new approaches are needed. Here, Anna Wec and colleagues used high-throughput screening and isolated several antibodies from llamas that could neutralize the XBB.1.5 and JN.1 variants of SARS-CoV-2. The researchers engineered these lead candidates into more potent bispecific antibodies, which can target multiple sites on the same protein. Furthermore, they introduced structural modifications that allow multiple antibodies to be delivered in tandem via mRNA. This mRNA strategy maximizes the antibodies’ ability to target SARS-CoV-2 as it evolves, and could potentially lower the high costs and manufacturing complexity that have held back previous bispecific antibody therapies. The platform neutralized a broad range of historical and current SARS-CoV-2 variants in serum and protected mice against infections with XBB1.5. “This platform may have applications in other therapeutic areas in which broad antigen coverage, resistance to escape, or simultaneous engagement of multiple disease-associated targets is desirable,” Wec et al. write.